Intensive care management of patients with liver disease: proceedings of a single-topic conference sponsored by the Brazilian Society of Hepatology

ABSTRACT Survival rates of critically ill patients with liver disease has sharply increased in recent years due to several improvements in the management of decompensated cirrhosis and acute liver failure. This is ascribed to the incorporation of evidence-based strategies from clinical trials aiming to reduce mortality. In order to discuss the cutting-edge evidence regarding critical care of patients with liver disease, a joint single topic conference was recently sponsored by the Brazilian Society of Hepatology in cooperation with the Brazilian Society of Intensive Care Medicine and the Brazilian Association for Organ Transplantation. This paper summarizes the proceedings of the aforementioned meeting and it is intended to guide intensive care physicians, gastroenterologists and hepatologists in the care management of patients with liver disease.

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Effect of communication skills training on outcomes in critically ill patients with life-limiting illness referred for intensive care management: a before-and-after study

BMJ Supportive & Palliative Care ◽

10.1136/bmjspcare-2016-001231 ◽

2017 ◽

Vol 9 (1) ◽

pp. e21-e21 ◽

Cited By ~ 8

Author(s):

Neil R Orford ◽

Sharyn Milnes ◽

Nicholas Simpson ◽

Gerry Keely ◽

Tania Elderkin ◽

...

Keyword(s):

Critical Care ◽

Intensive Care ◽

Clinical Outcomes ◽

Communication Skills ◽

Critically Ill Patients ◽

Care Management ◽

Skills Training ◽

Communication Skills Training ◽

Intensive Care Management ◽

Before And After

ObjectivesTo describe the effect of a communication skills training programme on patient-centred goals of care documentation and clinical outcomes in critically ill patients with life-limiting illnesses (LLI) referred for intensive care management.MethodsProspective before-and-after cohort study in a tertiary teaching hospital in Australia. The population was 222 adult patients with LLI referred to the intensive care unit (ICU). The study was divided into two periods, before (1 May to 31 July 2015) and after (15 September to 15December 2015) the intervention. The intervention was a 2-day, small group, simulated-patient, communication skills course, and process of care for patients with LLI. The primary outcome was documentation of patient-centred goals of care discussion (PCD) within 48 hours of referral to the ICU. Secondary outcomes included clinical outcomes and 90-day mortality.ResultsThe intervention was associated with increased documentation of a PCD from 50% to 69% (p=0.004) and 43% to 94% (p<0.0001) in patients deceased by day 90. A significant decrease in critical care as the choice of resuscitation goal (61% vs 42%, p=0.02) was observed. Although there was no decrease in admission to ICU, there was a significant decrease in medical emergency team call prevalence (87% vs 73%, p=0.009). The cancer and organ failure groups had a significant decrease in 90-day mortality (75% vs 44%, p=0.02; 42% vs 16%, p=0.01), and the frailty group had a significant decrease in 90-day readmissions (48% vs 19%, p=0.003).ConclusionsThe intervention was associated with increased PCD documentation and decrease in the choice of critical care as the resuscitation goal. Admissions to ICU did not decrease, and although limited by study design, condition-specific trajectory changes, clinical interventions and outcomes warrant further study.

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Intensive Care Management of Children with Liver Disease

Pediatric Hepatology and Liver Transplantation ◽

10.1007/978-3-319-96400-3_24 ◽

2019 ◽

pp. 409-432

Author(s):

Isabella Pellicioli ◽

Angelo Di Giorgio ◽

Lorenzo D’Antiga

Keyword(s):

Intensive Care ◽

Liver Disease ◽

Care Management ◽

Intensive Care Management

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Recommendations for Intensive Care Management in Small Animals Following Anaesthesia

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.1055/s-0038-1633069 ◽

1992 ◽

Vol 05 (02) ◽

pp. 66-70

Author(s):

Karol Mathews ◽

Doris Dyson

Keyword(s):

Intensive Care ◽

Care Management ◽

Small Animal ◽

Small Animals ◽

Monitoring Equipment ◽

Intensive Care Management ◽

Good Communication

Intensive care management can be provided in a small animal facility by centralisation of emergency and monitoring equipment. Good communication between all personnel involved in the case ensures that staff are prepared for complications that could arise related to recovery from anaesthesia.

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Drug Overdosage in Children

Anaesthesia and Intensive Care ◽

10.1177/0310057x7400200403 ◽

1974 ◽

Vol 2 (4) ◽

pp. 303-309 ◽

Cited By ~ 6

Author(s):

T. C. K. Brown ◽

F. I. Bishop ◽

G. C. Mullins

Keyword(s):

Intensive Care ◽

Respiratory Failure ◽

Emergency Treatment ◽

Care Management ◽

Tricyclic Antidepressants ◽

Conscious State ◽

Circulatory Failure ◽

Intensive Care Management ◽

Drug Overdosage

The epidemiology and prevention of drug overdosage in children is discussed. The emergency treatment of acute drug overdosage is outlined together with aspects of the intensive care management in relation to conscious state, convulsions, respiratory failure, circulatory failure and arrhythmias with some emphasis on tricyclic antidepressants.

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